Vision and implementation for the first U.S. carbon ion therapy center part I: Clinical rationale and the need for CIRT in the United States.
- 1Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA.
Abstract
Carbon ion radiotherapy (CIRT) has evolved into an established clinical modality over the past three decades. Owing to its unique physical and biological characteristics, CIRT has demonstrated favorable outcomes for selected malignancies characterized by radioresistance, proximity to critical organs, locally advanced disease requiring safe dose escalation, and recurrent tumors requiring re-irradiation. This review summarizes the physical and radiobiological rationale for CIRT, the evolution of international clinical practice and the clinical relative biological effectiveness models and dose prescription systems currently used in Asia and Europe. We discuss the differences between the modified microdosimetric kinetic model and Local Effect Model frameworks and their implications for interpreting and applying international clinical experience. We also describe the biological dose calculation framework adopted by Mayo Clinic Florida (MCF) to integrate established international CIRT experience into the first U.S. program. Published estimates of CIRT eligibility and need in the United States are reviewed to provide context for the anticipated U.S. patient population. This population includes many clinically complex disease sites characterized by proximity to critical organs, respiratory motion, anatomical variation, and the potential need for adaptive treatment. These clinical characteristics define important requirements for the first U.S. CIRT program and provide the foundation for the design philosophy and technical implementation described in the companion Part II article.
Related
- Vision and implementation for the first U.S. carbon ion therapy center part II: Design philosophy and clinical implementation.
- Interferon Therapy in Acute Myeloid Leukemia: Biological Rationale, Clinical Evidence, and Future Directions
- Targeted alpha therapy for solid tumors: biological rationale, clinical advances, and future perspectives
- Advances in Somatostatin Receptor-Targeting Peptide Receptor Radionuclide Therapy for Neuroendocrine Tumors: Biological Rationale, Combination Strategies, and Clinical Perspectives.
- Bipolar androgen therapy in castration-resistant prostate cancer: Biological rationale, clinical evidence, and future directions.
BibTeX
@article{liang2026vision,
title = {{Vision and implementation for the first U.S. carbon ion therapy center part I: Clinical rationale and the need for CIRT in the United States.}},
author = {Xiaoying Liang and Chris J Beltran},
journal = {Journal of applied clinical medical physics},
year = {2026},
month = oct,
doi = {10.1002/acm2.70876},
url = {https://europepmc.org/article/MED/42952142},
note = {CC BY},
}
RIS
TY - JOUR
TI - Vision and implementation for the first U.S. carbon ion therapy center part I: Clinical rationale and the need for CIRT in the United States.
AU - Xiaoying Liang
AU - Chris J Beltran
PY - 2026
DA - 2026/10/28
JO - Journal of applied clinical medical physics
DO - 10.1002/acm2.70876
UR - https://europepmc.org/article/MED/42952142
AB - Carbon ion radiotherapy (CIRT) has evolved into an established clinical modality over the past three decades. Owing to its unique physical and biological characteristics, CIRT has demonstrated favorable outcomes for selected malignancies characterized by radioresistance, proximity to critical organs, locally advanced disease requiring safe dose escalation, and recurrent tumors requiring re-irradiation. This review summarizes the physical and radiobiological rationale for CIRT, the evolution of international clinical practice and the clinical relative biological effectiveness models and dose prescription systems currently used in Asia and Europe. We discuss the differences between the modified microdosimetric kinetic model and Local Effect Model frameworks and their implications for interpreting and applying international clinical experience. We also describe the biological dose calculation framework adopted by Mayo Clinic Florida (MCF) to integrate established international CIRT experience into the first U.S. program. Published estimates of CIRT eligibility and need in the United States are reviewed to provide context for the anticipated U.S. patient population. This population includes many clinically complex disease sites characterized by proximity to critical organs, respiratory motion, anatomical variation, and the potential need for adaptive treatment. These clinical characteristics define important requirements for the first U.S. CIRT program and provide the foundation for the design philosophy and technical implementation described in the companion Part II article.
SN - 1526-9914
ER -